Job Description

Health & Medical Services Co

Resubmission Officer

Job id: 555647

04 Dec 2024

Job Location

United Arab Emirates

Experience

4 to 8 years

Qualification Level

Graduate

Job Function

Insurance / Claims

Skillset

Resubmission, Mediware System, Insurance, Claim, Good Communication Skills

Jobseeker Nationality

Jobseekers from any country

Resubmission Officer

Job Location: United Arab Emirates

Main Responsibilities:

• Check Remittance Advice in DHPO on daily basis.
• Download the RA and upload in Mediware system and process the RA in Mediware system.
• Check insurance claim denials prepared for accuracy and justification as per agreement, prior to resubmit claim to respective insurance companies.
• Responsible for submitting details of clinical rejections to physicians in order to clinically justify and resubmit the claim.
• Evaluate the claim rejection reason and generate justification based on physician remarks.
• Ensure coverage of claims, guide concerned staff for correct usage of claim forms, and approval papers.

Qualification and Skills:

• Degree preferably in medical field.
• Minimum 4 years UAE Hospital Experience mandatory.
• General knowledge of insurance contracts, terminology, rating practices and procedures, and legal insurance contract requirements.
• Knowledge of Interpreting and applying insurance laws, policies, rules and regulations.
• Strong interpersonal and organizational skills; attention to details.
• Knowledge of computer programs and applications.

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